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Older people with heart failure and general practitioners - temporal reference frameworks and implications for practice
- Authors:
- WATERWORTH Susan, et al
- Journal article citation:
- Health and Social Care in the Community, 19(4), July 2011, pp.412-419.
- Publisher:
- Wiley
Chronic illness changes one’s sense of time, and chronic disease management and palliative care have implication for health professionals’ use of time. The aim of the study was to identify the temporal reference frameworks that structure and give meaning to the experiences of time for older patients with heart failure and their general practitioners (GPs). Secondary analysis of qualitative data collected from 2 longitudinal studies, one in the United Kingdom and the other in New Zealand, was carried out. The UK study involved interviews with 44 older people with heart failure and 9 focus group discussions with primary health professionals during 2004–2005. The NZ study involved 79 interviews with 25 older people with heart failure and 30 telephone interviews with GPs during 2008–2009. Different temporal reference frameworks were identified for both patients and GPs. ‘Clock time’ was evident in how it structured the consultations. Both patients and GPs valued ‘needing time’, however there were tensions between ‘needing time’ and ‘wasting time’. For some GPs this involved creating space for ‘emotional time’. Being ‘known over time’ was important to both patients and GPs. The article concludes that understanding these multiple times is important for improving the quality of care for older people.
A qualitative study of nurses’ clinical experience in recognising low mood and depression in older patients with multiple long-term conditions
- Authors:
- WATERWORTH Susan, et al
- Journal article citation:
- Journal of Clinical Nursing, 24(17-18), 2015, pp.2562-2570.
- Publisher:
- John Wiley and Sons
Aims and objectives: To explore how nurses’ recognise depression in older patients with multiple long-term conditions and the strategies they use to support the patient. Background: Depression decreases an older person's quality of life and sense of wellness, and increases functional impairment. The positive role of nurses working with patients with long-term conditions is now being recognised internationally; however, there is a gap in the research about how nurses recognise depression in older patients and how this impacts on their practice. Design: This is a qualitative study informed by a constructivist grounded theory approach. Methods: In-depth telephone interviews were conducted with 40 nurses working in geographically diverse areas in New Zealand. Results: Having the conversation with older patients about their low moods, or specifically about depression was not something that all the nurses had, or felt they could have. While some nurses knew they could provide specific advice to patients, others believed this was not their responsibility, or within the scope of their role. Conclusion: Faced with an increasing number of older people with long-term conditions, one of which maybe depression itself or as a result of living with other long-term conditions, ongoing monitoring and support pathways are necessary to prevent further decline in the older person's quality of life and well-being. Relevance to clinical practice: Nurses in primary health care can build on current knowledge and skills to increase their capability to promote ‘ageing well’ with older people who have long-term conditions and depression. (Publisher abstract)